口腔医学研究

口腔医学研究 ›› 2017, Vol. 33 ›› Issue (10): 1068-1070.DOI: 10.13701/j.cnki.kqyxyj.2017.10.012

• 临床研究论著 • 上一篇    下一篇

颌骨放射性骨坏死的影像学特点

赵熠1，邹海啸2，吴丽芬2，王世平3，刘冰2*   

  1. 1. 武汉大学口腔医院修复科 湖北 武汉 430079；
    2. 武汉大学口腔医院口腔颌面外科 湖北 武汉 430079；
    3. 武汉大学口腔医院放射科 湖北 武汉 430079
  • 收稿日期:2017-08-04 出版日期:2017-10-20 发布日期:2017-10-24
  • 通讯作者: 刘冰,电话:13871116858
  • 作者简介:赵熠(1981~ ),男,博士,副主任医师,主要从事颌骨溶骨性疾病的研究。
  • 基金资助:
    第三批武汉中青年医学骨干人才培养工程

Imaging Features of Osteoradionecrosis of Jaws

ZHAO Yi1, ZOU Hai-xiao2, WU Li-fen2, WANG Shi-ping3, LIU Bing2*   

  1. 1. Department of Prosthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China;
    2. Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China;
    3. Department of Oral Radiology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China.
  • Received:2017-08-04 Online:2017-10-20 Published:2017-10-24

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摘要： 目的:评价头颈部恶性肿瘤治疗后颌骨放射性骨坏死的影像学特点。方法:对68例颌骨放射性骨坏死的临床、影像资料进行回顾性研究,包括原发瘤类型与部位、放疗结束至出现放射性骨坏死的时间、受累颌骨的影像学特点以及术后病理诊断等。结果:原发瘤主要是鼻咽癌和口腔癌。颌骨放射性骨死部位绝大多数(63例,91.18%)是下颌骨体或下颌体-升支区,较多(49例,72.06%)发生在放疗后5年内。骨小梁消失或结构紊乱、皮质中断是常见影像学表现,其次是死骨片与骨硬化,少数病例中可观察到病变骨邻近的软组织或肌肉增厚与强化。结论:CT是评价颌骨放射性骨坏死的较可靠方法,可明确病变范围并有利于鉴别肿瘤复发。

关键词: 放射性骨坏死, 头颈部, 恶性肿瘤

Abstract: Objective: To evaluate the imaging features of osteoradionecrosis of the jaws secondary to treatment of head and neck malignancy. Methods: We retrospectively reviewed clinical and imaging data of 68 patients with osteoradionecrosis of the jaws, including the type and site of primary tumors, the interval between the completion of radiotherapy and onset of osteoradionecrosis, imaging findings of the involved mandible or maxilla, postoperative pathological diagnosis. Results: Primary tumors were mostly nasopharyngeal carcinoma and oral cancer. The majority of osteoradionecrosis was involved in the body or body-ramus of the mandible (63 cases, 91.18%). Forty-nine cases (72.06%) of osteoradionecrosis were diagnosed within 5 years after radiotherapy. Loss or disorganization of trabecula and interruption of the cortical margin were observed in nearly all cases (89.7% and 77.94%, respectively), followed by sequestrum (42.65%) and bony sclerosis (33.82%), and soft tissue or muscle thickening adjacent to the affected bone in 6 cases. Conclusion: CT findings provide more reliable diagnostic tools for osteoradionecrosis of the jaws, and are able to determine the extent of involved bone and helpful to differentiate from tumor recurrence.

Key words: Osteoradionecrosis, Head and neck, Malignancy

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